Weight & Balance: Navigating FAA Policy on Weight Loss Meds

March 31, 2024
by Rocky Jedick MD, MBA
The Quick Fix to Weight Loss?

Attention, aviators! Have you ever considered turning to weight loss medications to shed those extra pounds? The use of medications initially designed to treat diabetes has recently gone mainstream as the newest strategy for weight loss. As the prevalence of obesity has surpassed over 40% of the US population, a larger number of pilots in this group will also be curious about shrinking the waistline thru pharmaceutical means.

But before you reach for that bottle of diet pills, it’s crucial to understand the Federal Aviation Administration’s (FAA) policy on weight loss medications.

Understanding the FAA’s Concerns

The FAA is tasked with ensuring the safety of air travel for both passengers and crew. One of their primary concerns regarding weight loss medications is the potential for adverse side effects that could compromise flight safety. Many weight loss medications can cause nausea, protracted vomiting, dizziness, drowsiness, or impaired judgment – all of which are serious hazards in the cockpit.

Additionally, since many of these medications were first used to treat diabetes, the FAA wants to ensure a pilot is not actually taking a given medication for Diabetes Mellitus. For this reason, a pilot taking even one of these approved medications (see below) must prove they are not actually diagnosed with Diabetes or Pre-Diabetes.

Any Airman on Weight Loss Medications must provide a few additional items to their AME on day of FAA Medical Exam: 

* Provide a current detailed clinical progress note from treating provider
* Hemoglobin A1C (Hgb A1C) within last 90 days (must be less than 6.5%)

FAA Regulations - Weight Loss Medications

The FAA has strict guidelines regarding the use of any medications by pilots, including weight loss medications. This is currently a rapidly moving target with significant changes to the FAA Policy in Oct 2023 and future modifications are anticipated. Currently, weight loss strategies for pilots can be separated into 4 broad categories: 

  1. Weight Loss treated with lifestyle interventions (typically exercise or dietary modifications) OR acceptable OTC meds such as the Lipase Inhibitors described below.
  2. Treatment with ONE Acceptable Diabetic Medication (alone or in combination with acceptable OTC Lipase Inhibitor) for Weight Loss
  3. Treated with TWO or more diabetic medications for Weight Loss
  4. Unacceptable Weight Loss Medications

Category 1 - Weight Loss thru Lifestyle Modifications & OTC Meds

* Over-The-Counter (OTC) Lipase Inhibitors - Orlistat, Alli, Xenical

* The AME must note this in Med Express during your FAA Medical Exam and CAN ISSUE YOU THE CERTIFICATE DAY OF EXAM!

Category 2 - Treatment with One Acceptable Diabetes Medication

See Green Section in above chart. Weight loss medications considered 'Acceptable' by the FAA as single agents or in combinations are:

* Metformin OR GLP-1 agonists - semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda)

* One of the above medications may be combined with the OTC Lipase Inhibitors.

* The AME utilizes the CACI Worksheet for Weight Loss Medications - IF CACI QUALIFIED, THE AME CAN ISSUE A MEDICAL CERTIFICATE AT EXAM!

Category 3 - Treatment with Combination or 'Conditionally Acceptable' Medications

* See Yellow Section in above chart

* Combination of two diabetic medications (such as metformin + GLP-1 Agonist)

* Any use of Tirzepatide (Mounjaro, Zepbound)


Category 4 - Unacceptable Weight Loss Medications

* See Red Section in above chart


Know Before You Fly - Observation Times

Each of the above 'Acceptable' Medications do have observation times that prevents a pilot from flying after initial use to assure that they will not have serious side effects. See the above chart for current required Observation Times after initiation and dosage change for each medication.

Before taking any weight loss medication, pilots should consult with an Aviation Medical Examiner (AME) to ensure compliance with FAA regulations.

Safe Alternatives

While weight loss medications may seem like a quick fix, they are not the only – or necessarily the safest – option for shedding excess weight. Pilots are encouraged to focus on maintaining a healthy lifestyle through regular exercise and a balanced diet. Not only is this approach safer in terms of flight safety, but it also promotes overall well-being and longevity.

Old School Strategies for Weight Loss

Some pilots may even decide to pursue bariatric surgery, which has its own unique concerns for flyers. Please consult with your AME any time you are uncertain how a medication or medical procedure may affect your ability to fly.


Weight loss medications may promise rapid results, but for pilots, safety always comes first. Before considering any medication – especially those that could impact your ability to fly – it’s essential to consult with an AME and fully understand the FAA’s policies and regulations. Remember, the sky is vast and full of possibilities, but it’s our responsibility as pilots to ensure that every flight is conducted with the utmost care and attention to safety. Fly safe, fly smart, and keep reaching for the clouds – the healthy way!

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